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Pleural effusion exudate

Ulku Aka Akturk, Dilek Ernam, Makbule Ozlem Akbay, Nagihan Durmus Koçak, Erhan Ogur, Ilim Irmak
OBJECTIVES: Pleural effusion is a common diagnostic and clinical problem. The differential diagnosis of pleural effusion may be difficult and may require several procedures, including invasive ones. Certain studies have investigated biochemical parameters to facilitate the diagnosis of exudative pleural effusion; however, it remains a challenging problem in clinical practice. We aimed to investigate the potential role of the neutrophil-lymphocyte ratio, which can be easily obtained by determining the cell count of the pleural fluid, in the differential diagnosis of exudative pleural effusion...
October 1, 2016: Clinics
Nanda B C, Mohapatra Bn, Majhi Cd
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Lisete Ribeiro Teixeira, Murilo B Dias, Roberta K B Sales, Leila Antonangelo, Vanessa A Alvarenga, Juliana Puka, Evaldo Marchi, Milena Marques Pagliarelli Acencio
BACKGROUND: Matrix metalloproteinases (MMPs) are responsible for the breakdown of the extracellular matrix and play an important role in the inflammatory processes of pleural exudates. The imbalance between MMPs and their inhibitors (TIMPs) is present in various pathological processes. OBJECTIVE: To evaluate the profile of MMPs and TIMPs in pleural effusions of different etiologies correlated with inflammatory markers. METHODS: The patients with pleural effusion due to tuberculosis (TB), cancer (CA) or transudate were prospectively evaluated...
September 27, 2016: Lung
Miloslav Marel, Libor Fila, Michaela Červená
UNLABELLED: The problems of pleural effusions are connected with many areas of medicine. The problem affects approx. 0.5 % of the population every year. The paper summarizes pathophysiological data relating to the emergence of effusions, their epidemiology, description of particular types of effusions and possibilities of treatment. More attention is paid to the differential diagnosis and therapy for malign pleural effusions. KEY WORDS: diagnostics - exudate - treatment - pleura - transudate...
2016: Vnitr̆ní Lékar̆ství
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
Adriana Lama, Lucía Ferreiro, María E Toubes, Antonio Golpe, Francisco Gude, José M Álvarez-Dobaño, Francisco J González-Barcala, Esther San José, Nuria Rodríguez-Núñez, Carlos Rábade, Carlota Rodríguez-García, Luis Valdés
BACKGROUND: Pseudochylothorax (PCT) (cholesterol pleurisy or chyliform effusion) is a cholesterol-rich pleural effusion (PE) that is commonly associated with chronic inflammatory disorders. Nevertheless, the characteristics of patients with PCT are poorly defined. METHODS: A systematic review was performed across two electronic databases searching for studies reporting clinical findings, PE characteristics, and the most effective treatment of PCT. Case descriptions and retrospective studies were included...
August 2016: Journal of Thoracic Disease
Animesh Ray, Vivek Nangia, R S Chatterji, Navin Dalal
We describe a middle aged previoulsy healthy female patient who presented with clinical features suggestive of acute heart failure. Investigations revealed very high NT pro-BNP, right heart enlargement, bilateral pulmonary alveolar edema and bilateral pleural effusion. In view of falling platelet counts and exudative pleural effusion inflammatory/infective causes were considered. Her Weil Felix test was strongly positive and IgM for scrub typhus also returned positive. She was started on doxycycline to which there was dramatic improvement...
July 2016: Lung India: Official Organ of Indian Chest Society
A Russell Moore, Emily Coffey, Sarah E Leavell, Greta Krafsur, Colleen Duncan, Kristy Dowers, Kelly S Santangelo
A 6-year-old, male castrated, mixed-breed dog was referred to the James L. Voss Veterinary Teaching Hospital at Colorado State University for bicavitary effusion. On examination, the dog was tachycardic and tachypneic with bilaterally decreased lung sounds. Thoracic and abdominal ultrasonic examination revealed pleural and peritoneal effusions, which were aspirated and submitted for fluid analysis and cytology. Both cavity fluids were classified as exudates with a large population of vacuolated mononuclear cells...
September 2016: Veterinary Clinical Pathology
José M Porcel
Pleural tuberculosis (TB) remains difficult to diagnose. In about two-thirds of the cases the diagnosis is reliant upon clinical suspicion along with consistent fluid biochemistries (i.e., lymphocytic predominant exudates) and exclusion of other potential causes for the effusion. Microbiological methods for a confirmatory diagnosis of pleural TB, which include acid-fast smears (Ziehl-Nelseen), cultures on solid media (Lowenstein-Jensen) and polymerase chain reaction tests from either pleural fluid or sputum samples, remain suboptimal since they are positive in only a minority of patients...
August 2016: Annals of Translational Medicine
Marios Panagiotou, Andriana I Papaioannou, Konstantinos Kostikas, Anna Takou, Maria Paraskeva, Alexandros Kalkanis, Filia Diamantea, Emmanuil Kastanakis, George Maropoulos, Vasiliki Filaditaki, Napoleon Karagianidis
INTRODUCTION: Growing evidence suggests a role of vitamin D in various cancers but the significance of vitamin D in malignant pleural disease remains unexplored. We sought to investigate the concentration and diagnostic role of 25-hydroxyvitamin D (25(OH)D) in malignant pleural effusions. MATERIALS AND METHODS: Prospective study of consecutive treatment-naïve patients with a new diagnosis of pleural effusion. RESULTS: Seventy-eight patients were studied, 45 of whom had malignant pleural effusions...
August 9, 2016: Clinical Respiratory Journal
Joon Young Choi, Sung-Hwan Kim, Seung-Ki Kwok, Jung Im Jung, Kyo-Young Lee, Tae-Jung Kim, Ji Young Kang
Behçet's disease is a systemic disease which may involve various organs. We describe a case of a patient diagnosed as pleuropericardial involvement of Behçet's disease. A 30-year-old woman visited our clinic presented with left pleuritic chest pain for s days. She had been diagnosed as Behçet's disease and admitted to our clinic due to pericardial and pleural effusion repeatedly in past two years. In the previous studies, effusion analysis revealed to be lympho-dominant exudate with high adenosine deaminase level...
July 2016: Journal of Thoracic Disease
Kan Zhai, Yong Lu, Huan-Zhong Shi
Although it is curable, tuberculosis remains one of the most frequent causes of pleural effusions on a global scale, especially in developing countries. Tuberculous pleural effusion (TPE) is one of the most common forms of extrapulmonary tuberculosis. TPE usually presents as an acute illness with fever, cough and pleuritic chest pain. The pleural fluid is an exudate that usually has predominantly lymphocytes. The gold standard for the diagnosis of TPE remains the detection of Mycobacterium tuberculosis in pleural fluid, or pleural biopsy specimens, either by microscopy and/or culture, or the histological demonstration of caseating granulomas in the pleura along with acid fast bacilli, Although adenosine deaminase and interferon-γ in pleural fluid have been documented to be useful tests for the diagnosis of TPE...
July 2016: Journal of Thoracic Disease
Yun Su Sim, Dong Gyu Kim, Tae Rim Shin
BACKGROUND: The soluble receptor for advanced glycation end products (sRAGE) may have an inflammatory or homeostatic function in lung tissue. The aim of this study was to assess the usefulness of sRAGE as a diagnostic marker for exudative pleural effusions, which are common manifestations of a variety of diseases. METHODS: Patients with an undiagnosed pleural effusion were prospectively enrolled between January 2013 and January 2015. Samples of blood and pleural fluid were centrifuged and the supernatant stored at -70 °C...
July 2016: Journal of Thoracic Disease
Aggeliki Psatha, Demosthenes Makris, Theodora Kerenidi, Zoe Daniil, Theodoros Kiropoulos, Konstantinos Gourgoulianis
BACKGROUND: Vascular endothelial growth factor (VEGF) may play a role in pleural fluid formation, as it represents a potent inducer of capillary permeability. We aimed to investigate the diagnostic utility of VEGF levels in pleural fluid and serum in patients with pleural effusions with initially negative diagnostic work up. METHODS: Seventy-one patients with exudative lymphocytic pleural effusions undiagnosed after initial diagnostic work up were enrolled in this prospective study and their clinical course was followed up to 24 months...
July 2016: Journal of Thoracic Disease
Jaehee Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Chang Ho Kim
PURPOSE: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are usually distinguished by cellular predominance and pleural fluid adenosine deaminase (ADA) levels. However, both diseases may occasionally show similar neutrophilic predominance and high ADA levels. In such cases, the differential diagnosis between TPE and PPE is challenging and has been rarely investigated. METHODS: A retrospective study was conducted on TPE and PPE patients with neutrophilic exudate and pleural fluid ADA levels ≥40 U/L...
August 3, 2016: Infection
Kelechi E Okonta, Emmanuel O Ocheli, Peter D Okoh
Background. There are no available literatures on massive pleural effusions (MPE) in our country. Aim. To determine the aetiology of MPE and compare the mortality rate between malignant and nonmalignant MPE in adult Nigerians. Methods. A prospective study of all the patients diagnosed with nontraumatic pleural fluid collections for one year in two tertiary federal hospitals in Southern Nigeria. A total of 101 consecutive patients with pleural fluid collections were studied. Diagnoses were made by clinical features and laboratory and radiological investigations...
2016: Advances in Medicine
Semiha Bahceci Erdem, Hikmet T Nacaroglu, Rana Isgüder, Canan S Unsal Karkiner, Hüdaver Alper, Demet Can
Hydrocarbon aspiration (HA) can cause significant lung disease by inducing an inflammatory response, hemorrhagic exudative alveolitis, and loss of surfactant function. The most serious side effect of HA is aspiration pneumonia. Pneumothorax, pneumatocele, acute respiratory distress syndrome (ARDS), pulmonary abscess, bronchopleural fistula, bilateral hemorrhagic pleural effusion and pyopneumothorax were previously reported. Hereby we report a patient hospitalized due to aspiration pneumonia who developed pleurisy and pneumothorax after drinking paint thinner...
August 1, 2016: Archivos Argentinos de Pediatría
George Williams, Dipen Kadaria, Amik Sodhi
BACKGROUND Myelomatous pleural effusion (MPE) is a rare occurrence in patients with multiple myeloma (MM). Fewer than 20 cases of MPE have been reported as an initial manifestation of MM. Extramedullary plasmacytoma (EMP) occurs in fewer than 5% patients with MM, and mediastinal EMP is even rarer, with only about 80 cases reported in the literature. We present a case study involving a patient with concurrent MPE and mediastinal EMP as an initial manifestation of MM. CASE REPORT The patient was a 74-year-old nonsmoking female with a 3-month history of exertional dyspnea and back pain...
2016: American Journal of Case Reports
Carlos A Amado, María T García-Unzueta, M Carmen Fariñas, Francisca Santos, María Ortiz, Pedro Muñoz-Cacho, José A Amado
BACKGROUND: Vitamin D and vitamin D dependent antimicrobial peptides such as Cathelicidin (LL-37) and β-defensin 2 have an important role in innate and adaptative immunity, but their role in pleural effusions has not been studied before. METHODS: Serum and pleural fluid samples from 152 patients with pleural effusion were collected, corresponding to 45 transudates and 107 exudates, 51 infectious effusions (14 complicated and 37 non-complicated), 44 congestive heart failure effusions and 38 malignant effusions...
2016: BMC Pulmonary Medicine
Chang Ho Kim, So Yeon Lee, Yong Dae Lee, Seung Soo Yoo, Shin Yup Lee, Seung Ick Cha, Jae Yong Park, Jaehee Lee
Objective Although tuberculous pleural effusion (TPE) is commonly characterized by lymphocytic predominance and high adenosine deaminase (ADA) levels, it may present with neutrophilic predominance or low ADA levels, which are more commonly found in parapneumonic effusion (PPE) or malignant pleural effusion (MPE), respectively. A few studies have observed that the atypical pleural fluid profiles of these cases of TPE may resolve at follow-up thoracentesis. However, these observations were incompletely analyzed and lacked comparison with proper control groups...
2016: Internal Medicine
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